A Novel Application of the Child Psychiatry Access Program Model to Inpatient Psychiatry: The Transitional Care Coordination Program.

Abstract

Pediatric patients who have been discharged from psychiatric hospitalizations are at high risk of negative outcomes, especially if they do not connect to outpatient mental health services. This paper describes the development and implementation of the Transitional Care Coordination Program (TCCP), a novel adaptation of the Child Psychiatry Access Program (CPAP) model, to provide mental health consultation and care coordination services after psychiatric hospitalization. The program offered discharging patients' pediatric primary care providers telephonic child psychiatry consultations and three months of care coordination for patient families over multiple timepoints. Between March 2020 and November 2021, 163 unique patients were enrolled in the TCCP from 170 admissions. Patient families from 89 admissions (52% of total) were reached and participated in the TCCP, with 22 of those (25%) requesting new behavioral health provider resources and 39 (44%) requesting other behavioral health supports. The TCCP reached out to 110 (65% of total) primary care providers, none of whom requested a psychiatric consultation. Findings support the initial feasibility of a novel adaptation of the CPAP model for preemptive support at psychiatric hospitalization discharge. This is the first program of its kind, showing promise as a way for existing CPAPs to leverage their infrastructure to help families connect to needed mental health care after discharge and potentially prevent readmissions or other adverse outcomes. More research is needed to understand its efficacy and applicability to other settings.